title: A cluster of fulminant, fatal necrotizing community-associated methicillin-resistant Staphylococcus aureus pneumonias.
abstract: Community-associated methicillin-resistant Staphylococcus aureus is a frequent cause of skin and soft-tissue infections and is increasingly identified as a cause of pneumonia in immunocompetent patients. Panton-Valentine leukocidin, one of several leukocytotoxic peptides secreted by these cocci, is associated with increased virulence. A cluster of 3 unrelated patients with fatal pneumonia presumably caused by community-associated methicillin-resistant S aureus positive for Panton-Valentine leukocidin were treated in a 3-week period. Despite aggressive care and appropriate, timely administration of antibiotics, all 3 patients died. This article reviews the clinical and laboratory features suggestive of this lethal isolate, including unique findings on Gram stains of sputum.
authors.affiliation: Department of Emergency Medicine, Alameda County Medical Center, Oakland, California 94602, USA.
authors.forename: Aparajita
authors.initials: A
authors.lastname: Sohoni
authors.forename: Colin
authors.initials: C
authors.lastname: Feeney
authors.forename: Larry
authors.initials: L
authors.lastname: Lambert
authors.forename: Robert
authors.initials: R
authors.lastname: McCabe
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001427:Bacterial Toxins; D017714:Community-Acquired Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology*; D005098:Exotoxins; D005260:Female; D006801:Humans; D007956:Leukocidins; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D008875:Middle Aged; D011023:Pneumonia, Staphylococcal / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents; D001427:Bacterial Toxins; D005098:Exotoxins; D007956:Leukocidins; C078284:Panton-Valentine leukocidin